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Acute Outpatient Hospital Manual for MassHealth Providers

The Acute Outpatient Hospital Manual guides providers to the regulations, administrative and billing instructions, and service codes they need.

Administrative regulations and billing regulations apply to all providers and are contained in 130 CMR 450.000. These regulations are reproduced as Subchapters 1, 2, and 3 in this and all other manuals.

Program regulations cover matters that apply specifically to the type of provider for which the manual was prepared. For acute outpatient hospital providers, those matters are covered in 130 CMR 410.000, reproduced as Subchapter 4 in the Acute Outpatient Hospital Manual. 

In-state acute outpatient hospitals should also refer to the RFA (Request for Application) signed by the hospital for the current rate year for additional requirements.

Table of Contents

Subchapters 1 through 3: Administrative and Billing Regulations for all MassHealth Providers

Subchapter 4: Acute Outpatient Hospital Providers Regulations

Subchapter 5: Administrative and Billing Instructions for all MassHealth Providers

Subchapter 6: Acute Outpatient Hospital Service Codes

Appendices for All MassHealth Providers (includes appendices A, C, T, U, V, W, X, Y, and Z)

Appendices for Acute Outpatient Hospital Providers (includes appendices D, E, and F)



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